Context and background
The promise of ICT in healthcare is that it facilitates networking, citizen-centred information sharing and exchange, transparency, and collaboration between different stakeholders. Healthcare professionals should be more empowered in their role of providing healthcare. Electronic Health Records (EHRs), in particular, are expected to facilitate seamless continuation of healthcare provision involving various specialists at different locations and across the whole healthcare chain as needed. eHealth also allows the individual citizen to become more independent, more proactive, and a more responsible partner in the system. By being able to access easily the information about their condition, treatment options and health choices,, citizens will be more empowered. This should help to maximise health and optimise healthcare provision.
Evidence shows that ICT-supported healthcare, or more generally eHealth, indeed has the potential to help achieve these improvements and contain cost explosions by enabling healthcare providers to use their resources to better effect, thus expanding their capacity and performance to meet increasing demand.1
Nevertheless, progress in integrating eHealth into daily healthcare practices is below expectations. A major reason for the slow progress is "the lack of awareness of benefits of existing interoperable Electronic Health Records (EHR) and electronic Prescription (ePrescription) systems and services. Therefore, there is a need to disseminate existing best practices and the associated benefits as well as to examine existing methodologies of assessment and to propose common approaches to proving benefits of interoperable solutions using coherent and quantitative (scientific) methods."2 We would add that the lack of awareness is to some extent caused by lack of sound empirical evidence.
Precisely where the claimed benefits will accrue, and for whom, is a contentious issue. Anderson et al. in ‘Healthcare Spending and the use of Information Technology in OECD countries’ claim that it is "recognised that benefits and cost savings accrue primarily to patients and insurers, not to providers" 3. Other sources, such as our eHealth IMPACT (eHI) study, come to different conclusions. In some cases this lack of benefits for healthcare providers can indeed be observed, but, across all ten eHI sites evaluated in 2005 and 2006, providers gained about 52% or the majority of all benefits, with an estimated monetary value that exceeds their eHealth investment substantially. Healthcare providers and policy makers seem not to be adequately aware of the benefits they can gain from eHealth, partly because benefits are far too often erroneously associated with cash savings, which are as a matter of fact much lower and sometimes even negative.
- Karl A. Stroetmann, Tom Jones, Alexander Dobrev, Veli N. Stroetmann, "eHealth is Worth it - The economic benefits of implemented eHealth solutions at ten European sites", Luxembourg: Office for Official Publications of the European Communities, 2006 (56 pp. - ISBN 92-79-02762-X), available online: http://www.ehealth-impact.org
- Tender specifications: Study on Economic Impact of Interoperable Electronic Health Records and ePrescription in Europe, SMART N°2007/0048 – OJ 2007/S 100-122426, p.5
- G. F. Anderson et. al., "Healthcare Spending and the use of Information Technology in OECD countries" in Health Affairs, Volume 25, Number 3, May/June 2006